Arteaga-Gallegos IY, Ponce-Gallegos MA, Paz-Velarde BA, Chávez-EstradaV, Correa-De León J, Mendoza-Mujica MN, Campechano-Aguirre JI, Andrade-Castellanos CA

Language: Spanish
References: 12
Page: 240-245
PDF size: 224.55 Kb.

ABSTRACT

Background: Multiple myeloma is a malignant neoplasm of plasma cells that represents about 10% of hematological neoplasms. The most frequent clinical manifestations are anemia, hypercalcemia, renal failure, and lytic bone lesions. Fever is usually a very rare manifestation.
Clinical case: A female patient with a history of fever of up to 40°C and fatigue of one year of duration who, when hospitalized, revealed normochromic normocytic anemia with incompatibility to all blood groups. Infectious causes were ruled out by chest X-ray, thoraco-abdominal computed tomography, blood and urine cultures, baciloscopies and GeneXpert, all of which were negative. After addressing the anemia, a bone marrow aspirate was performed, finding more than 80% cellularity based on plasma cells, as well as stacked erythrocytes and protease background, stablishing the diagnosis of multiple myeloma. The patient never had hypercalcemia, renal function was preserved, and lytic bone lesions were not evident.
Conclusions: Fever is a rare symptom in patients diagnosed with multiple myeloma. Therefore, in a patient with a diagnosis of fever of unknown origin multiple myeloma turns out to be a diagnosis that is not initially suspected, and it lowers the suspicion even more when the clinical picture is presented in an atypical or nonspecific way, as in the case of our patient. However, as it is a hematological neoplasm, it will be part of the differential diagnoses.

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